How to Sleep Better When You're Burnt Out: A Tiered Approach

In my last post, I talked about why sleep can feel impossible even when you're exhausted, the science behind the sleep-burnout loop, and some of the most common reasons sleep struggles show up in the first place. If you haven't read that one yet, it's worth starting there, understanding why sleep is hard often makes the how of improving it feel less like a losing battle.

This post is about that how. The solution for sleep issues should be as nuanced and individualized as the issues you're facing, so rather than a one-size-fits-all list of tips, I want to walk you through a tiered approach: start with what's easiest to rule out, then work your way toward the deeper, more personal layers underneath.

A quick note before we dive in: these tiers aren't strictly sequential. You don't need to "finish" Tier 1 before trying something in Tier 2 or 3, think of them more as different angles to explore, not a rigid checklist.

Tier 1: Identify and Treat Underlying Medical Causes

I always recommend requesting bloodwork and/or a sleep study from your family doctor to rule out any potential medical causes. Addressing nutrient deficiencies and accessing treatment for sleep disorders, like a CPAP machine, can alone make a significant difference.

If you know that chronic pain or illness is a factor in your sleep issues, following your corresponding healthcare practitioner's treatment plan, whether this be regular manual treatments, exercises, or medication, is important. Following the prescribed treatment plan may not eliminate the pain, but it can help keep it more manageable. You may also want to consult your doctor about any medication side effects that may be contributing to sleep difficulties. In some cases, an alternative medication or timing your dosing differently may be an option.

Tier 2: Improve Sleep Hygiene

This might get an eye roll and feel overly simplistic. But shifting our lifestyle habits is one of the quickest and simplest next steps to improving sleep. Most of us know what good sleep hygiene looks like, but that doesn't mean we always follow it (speaking as someone who still falls into patterns of late afternoon iced coffees and late-night scrolling from time to time). The most impactful shifts you can make include:

Keeping sleep and wake times as consistent as possible. This is one of the most impactful changes you can make to help regulate your circadian rhythm. I know this is particularly tough for shift workers or parents with kiddos with unpredictable sleep. We're not looking for perfection, but any small changes you can make, like starting your kids' wind-down routine around the same time each night, or getting back to a regular sleep schedule as soon as possible after a night shift, count.

Keep naps short and early. If you nap, aim for 20-30 minutes, and earlier in the day rather than late afternoon. Longer or later naps can eat into your sleep pressure for the night, making it harder to fall asleep when bedtime actually arrives.

Reserve the bed for sleep and sex. A restful activity like reading or journaling in bed is okay too, so long as you keep it close to your bedtime as you're winding down. Our brain is always making connections, and the more time you spend in your bed during the daytime or while engaging in stimulating activities, the more your brain will associate the bed with not sleeping. If you're struggling to fall asleep, try moving from the bedroom to another space if it's been more than 20 minutes, and engage in a quiet, low-stimulation activity there instead.

Avoid caffeine for 6-8 hours before bedtime. Caffeine stays in your system for approximately 5-7 hours for the average person. However, everyone has a different tolerance and sensitivity, some people can have it later without much impact on sleep, while others may need to cut it off earlier. Pay attention to your body’s unique response.

Modify your environment. Your body temperature rises during sleep, so setting the thermostat lower and/or having a fan can help you stay cool. Experiment with what helps you from a sensory standpoint too: blackout curtains, a sleep mask, earplugs (I’m a Loop super fan!), and white noise machines can all be useful tools.

Aim to get daily movement and morning sunlight in your eyes. Movement is an excellent way of expending energy and regulating your nervous system, which can make sleep easier. Sunlight, particularly in the early morning soon after waking up, as well as in the early evening, can help regulate your circadian rhythm as well.

Avoid screens close to bedtime. Easier said than done, I know, but swap your late-night scrolling for stretching, reading, journaling, or something without the blue light. A couple of tips to help: try charging your phone away from your bedside, or use apps like Freedom or Opal that restrict your usage during certain times of day.

Be mindful of alcohol. It's tempting to reach for a glass of wine to unwind, and it can help you fall asleep faster. But alcohol fragments sleep later in the night and suppresses REM, so the sleep you get ends up being lower quality, even if it feels like it helped in the moment.

Tier 3: Calm an Anxious Mind and Body

If you've worked through the above and you're still struggling with sleep, I'd suggest asking yourself the following questions:

• When I lay down to sleep at night, what do I notice? What interferes with falling asleep?

• When I wake up in the middle of the night or early morning, what typically wakes me? What am I thinking or feeling upon waking up? What prevents me from falling back asleep?

Your answers to these questions are useful clues, and can help you figure out the right strategy for you. It may be helpful to keep a sleep diary to build more awareness here.

If Your Mind Is Racing With To-Dos or Worries

Write it out. Some people find it useful to jot down the things they need to get done the following day, or their worries, before going to sleep. This can free up a little headspace.

Try cognitive shuffling. Choose a random word with five or more letters, then visualize as many things as you can starting with each letter. For example, if your word is GIRAFFE, you'd start with G, visualizing different things starting with that letter (a garage, a guinea pig, a golf ball), then move to I, and so on. This technique works well because it takes just enough effort to pull your mind away from your worries and toward something neutral, without requiring so much effort that it keeps you awake.

Practice defusion. Defusion means "de-fusing" from your thoughts. One of my favourite exercises for this is to visualize a gently flowing stream, picturing your thoughts as leaves on that stream. When a thought, image, or memory arises while you're trying to fall asleep, picture that leaf floating by in its own time.

If You Feel Too "Wired"

Wait until you're actually tired. Try not to attempt sleep when you're feeling completely alert or wired. Establish a calming wind-down routine that doesn't involve screens - a hot shower, a sleepytime tea, a good book (though avoid anything too stimulating, like a thriller or mystery) - and turn the lights out once you're tired.

Try progressive muscle relaxation. Starting at your toes and ending with the muscles of your forehead, tense one muscle group as you inhale, then release on the exhale. This can help discharge excess energy and relax your body.

Try paced breathing. Making your exhale longer than your inhale, for example, breathing in for 4 counts and out for 6-8, activates your parasympathetic nervous system, the part responsible for rest and digestion, rather than fight-or-flight. A physiological sigh (a double inhale through the nose, followed by a long, slow exhale through the mouth) works the same way and can be done in bed without needing to sit up or focus on counting.

Manage stress throughout the day. This applies to all causes of sleep difficulties, and it's something we touched on in my last post: if you're constantly ‘on’ through the day without pausing to release that stress, through movement, connection, or creative outlets, for example, it accumulates in your system and makes it much harder to relax enough to fall asleep at night.

Resist the urge to check the clock. If you're lying awake, checking the time can quietly ramp up pressure and frustration, which makes falling back asleep even harder. If you can, turn your clock away or put your phone out of reach so it's not a temptation.

If Nightmares Are to Blame

Try imagery rescripting. For recurring nightmares, write down the dream, then write a more positive or neutral ending, before the scary part happens. Use your imagination here, anything is possible. Rehearse this new version for 5-10 minutes a day before you go to sleep.

Nightmares can also be closely connected to trauma, something we explored more in my last post. For some individuals, trauma processing therapies, such as Accelerated Resolution Therapy (ART), can be very effective for reducing the frequency and intensity of nightmares.

Key Takeaways

• Start with what's easiest to rule out (medical causes), then work through sleep hygiene, then the deeper emotional layers, but these tiers don't need to happen in a strict order.

• Small, consistent changes to your sleep-wake schedule and environment often make a bigger difference than they seem like they should.

• If your mind won't quiet down at night, techniques like cognitive shuffling, defusion, and writing out your worries can help interrupt racing thoughts.

• Persistent nightmares or a "wired" nervous system may point to something deeper, like unprocessed stress or trauma, worth exploring with support.

  
  

Improving sleep rarely happens overnight (pun intended), and that's okay. Some of these shifts you can start tonight, others might take some trial and error, and a few might point you toward a conversation with your doctor or a therapist. Wherever you're starting from, you don't have to figure it all out alone.

If sleep struggles have been tangled up with anxiety, burnout, or something that feels bigger than habits alone can fix, that's exactly the kind of thing I help clients work through. My calendar has some openings for a free 15-minute consultation, book here if you'd like to talk it through.